All your comments about the benefits, hurdles and politics of ObamaCare are spot on. We’ll just have to see how it plays out. I wish you luck.

]]>By: GV Hastehttp://www.ibabuzz.com/politics/2013/05/16/norcal-house-dems-knock-obamacare-repeal-vote/comment-page-1/#comment-133215
Sat, 18 May 2013 18:00:48 +0000http://www.ibabuzz.com/politics/?p=23182#comment-133215I’m all for the general concept of Obamacare.
I will benefit. I now self insure with Kaiser at $610 per month (that with $50 co-pays for office visits and no drug coverage)
I spend so much on my monthly payment that I can’t afford to see the doctor for a extra $50 unless its something very important.

The time between, enrollment opening, October 1st and the end off the first 6 months of the new plans, July 1st 2014, are going to be brutal.
California may be one of the most prepared but it will still be chaos. Other states are so confused they may postpone it for a year.

A couple of HUGE problems with the system.

Employers with less than 50 employees don’t have to offer coverage. Expect many companies with 60 or 70 employees to drop employees, or hire them as independent contractors.

Employers don’t have to provide health care to employees with health care if they don’t work 30 hours a week. Expect huge numbers of 29 hour a week employees to become the norm.

Walmart, and loads of others retailers will have 4 x 7 hour employees, or some variation.
Then those employees will have to get health care on the exchange at a reduced rate.

I wouldn’ doubt that Obamacare will be issue #1 in the 2014 congressional elections.

One nice feature for those 55 thru 64, is that not only will they not have to fear pre existing conditions, but the cannot be charged more than 3 times what a 20 or 27 year old can be charged.
High, but not insanely high. No more of the $1,600 per month horror stories for skimpy coverage.
Or the simple “high blood pressure” exclusions from coverage. Not to mention a prior bout of cancer wherein NO ONE would even discuss coverage.

Also, depending on how immigration reform plays out, the whole issue of health care for undocumented workers is huge, especially in California.
At least $700 million huge per year. Probably much much higher in reality.

Yes, indeed, that old reliable parliamentary trick known as a majority vote.

There are things about this law that I don’t like, including the manner in which it is financed. They should have just gone to a series of regional insurance exchanges, instead of this mishmash of state-run and federal exchanges. And I would have found a way to do it without the individual mandate (a Heritage Foundation and Newt Gingrich idea implemented by Mitt Romney as his launching pad for a presidential run in 2008).

I would love to have seen a law that had at least some GOP backing. It might have been a less ambitious plan, but it would have had bipartisan support and provided a building block for progress later. It would have avoided all the “death panel” nonsense. Problem is, Republicans had no intention of engaging on anything dealing with health care. There was no Republican support to be had on any kind of plan. If Obama had proposed 2 aspirin and a good night’s rest for low income cancer patients, Republicans would have called it a government takeover of the health care system.

They wanted an issue for 2010, and they made one happen with all the phony town hollering meetings. They knew from the 2008 Dem primaries that health care was the Dem’s signature domestic issue and planned from the beginning to demagogue it no matter what the Dems proposed. Dems helped by having bills written by 5 separate congressional committees.

]]>By: Publiushttp://www.ibabuzz.com/politics/2013/05/16/norcal-house-dems-knock-obamacare-repeal-vote/comment-page-1/#comment-132965
Fri, 17 May 2013 22:02:45 +0000http://www.ibabuzz.com/politics/?p=23182#comment-132965This is what happens when one party unilaterally passes a major bill with absolutely zero support from the opposing party. There has been more bi-partisan support in its repeal than its passage. The way this bill was rammed through using parliamentary tricks will forever curse it. Despite all of the free stuff this act gives to the wanting this bill is more unpopular today than it was in 2010.
]]>By: JohnWhttp://www.ibabuzz.com/politics/2013/05/16/norcal-house-dems-knock-obamacare-repeal-vote/comment-page-1/#comment-132964
Fri, 17 May 2013 21:58:29 +0000http://www.ibabuzz.com/politics/?p=23182#comment-132964@3 Elwood

Glad you asked.

It’s more like 45 million uninsured, because 15 million do manage to get coverage on their own in the mostly unregulated individual insurance market, as dysfunctional and often predatory as that market is. Trust me, I know. The 15 million already covered will migrate to the exchanges (where they will have more choice, transparency and consumer protection). ObamaCare is expected to eventually cover 30 million of the 45 million uninsured.

Staying on the parent’s employer policy up to 26 isn’t necessarily a cost hit. People that age are cheap to cover. And I believe the employer can build any extra cost into the employee’s premium share for dependent coverage, although most won’t. Three million people in this age group have already obtained coverage since this went into effect.

As GV Haste notes, the additional insured will reduce the amount of care provided in expensive ER’s and the cost shifting from the uninsured to the insured.

As for pre-existing conditions, this levels the playing field. If you get coverage through an employer for yourself and dependents, you get it regardless of your health status. Older employees don’t pay more than young employees, and sicker employees don’t pay more than healthy ones. Females don’t pay more than males. Only people who have to get insurance on their own have been subjected to that discrimination. The health insurance exchanges are designed to create the type of risk pools that people in employer plans have always enjoyed.

But will this cost taxpayers? Yes. Because people up to certain income levels will be eligible for premium support (similar to what Paul Ryan proposed for Medicare). Personally, I think the subsidies are too generous in terms of the level of income you can have and still get premium support. On the other hand, if you are elderly and on Medicare, you are subsidized big time. If you get coverage through an employer, you are subsidized because the employer’s cost of providing that coverage is not included in your taxable income. You don’t get any tax break when your buy insurance on your own with your own money. Why should the people who buy insurance on their own be the only ones who don’t get subsidized?

I don’t buy the argument that shortage of providers is a good reason to not expand coverage. Talk about health care rationing! Sorry, no room left in the lifeboat – drown! The market will eventually adjust. I think what we will see is more primary care docs going to work for hospitals, large group practices and organizations like Kaiser, so that they can get a good salary, practice medicine and not have to deal with the headaches of private practice.

And let’s not forget that the countries that have some form of universal coverage spend far less per capita and as a percentage of GDP than we do. Socialist fools! We’ve got the best doctors, the best medical schools and most of the top tier medical centers. But we’ve got a really stupid hodgepodge delivery system. Unfortunately, ObamaCare adds on to that hodgepodge rather than giving the system the enema and reconstructive surgery it needs.

]]>By: GV Hastehttp://www.ibabuzz.com/politics/2013/05/16/norcal-house-dems-knock-obamacare-repeal-vote/comment-page-1/#comment-132950
Fri, 17 May 2013 20:29:47 +0000http://www.ibabuzz.com/politics/?p=23182#comment-132950Well there will be growth in usage of medical care to be sure. A study of Oregon’s medicade program showed that when they conducted a experiment.

On the other hand, many of these new folks would otherwise only show up later in emergency rooms and then who do you think paid for that?

Quite aside from the money, the sheer logistics of this transformation over the next 8 months is going to be huge and chaotic. Hopefully California’s transition will be smoother than most states.

Very important in all of this is IF newly legalized undocumented immigrants will be included in any way.
Elements in the state legislature are trying to fund programs that will cover these undocumented immigrants.

I believe Brown is opposing that inclusion, seeing it as a budget buster.

]]>By: Elwoodhttp://www.ibabuzz.com/politics/2013/05/16/norcal-house-dems-knock-obamacare-repeal-vote/comment-page-1/#comment-132947
Fri, 17 May 2013 20:03:46 +0000http://www.ibabuzz.com/politics/?p=23182#comment-132947It will be what in the vernacular is called a cluster****.

And how is all this largesse (pre-existing conditions, dependents to age 26, 60 million uninsured) to be paid for?

Where are all the needed doctors, nurses, facilities to come from? Doctors are dropping out of the practice of medicine.

I am a member of the TMTEA party. Taxed more than enough already.

]]>By: JohnWhttp://www.ibabuzz.com/politics/2013/05/16/norcal-house-dems-knock-obamacare-repeal-vote/comment-page-1/#comment-132840
Fri, 17 May 2013 07:04:46 +0000http://www.ibabuzz.com/politics/?p=23182#comment-132840Republicans are in overdrive to make sure it’s a mess. No funding for outreach and then criticizing the Secretary of HHS for going out and soliciting private funds instead. But the fact remains that there are 60 million people who don’t have access to health coverage through an employer plan or a government program such as Medicare.

Only about 15 million of those buy coverage on the individual insurance market because of either cost or pre-existing conditions. Most of the other 45 million people want coverage and some how, some way will find their way to the private insurance exchanges despite GOP efforts to muddy the water.

I never thought the controversial individual mandate was even necessary, because far more of the people who don’t have coverage want it than don’t want it. That was Obama’s position too during the 2008 campaign. But, once he got into office, he was pressured by the insurance companies and their friends in Congress to go with the mandate.